Jadee's Nursing Agency

Updated 16 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. The registered manager was also the nominated individual and owner. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 24 May 2023 and ended on 6 June 2023. We visited the location’s office on 25 May 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, including an action plan shared with us by the provider. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people, and 4 people’s relatives to gain their feedback on the care and support provided. We spoke with 5 staff members, including the registered manager, the manager (who is also a director of the company), team leaders / supervisors, and care workers. We sent out surveys and received and reviewed responses from 7 further staff members. We looked at 4 staff recruitment files, 4 people’s care plans and multiple medication records. We also looked at a variety of documents relating to governance and oversight of the service, including audits, action plans, policies and procedures. A specialist CQC team analysed data from the provider’s electronic call monitoring system, to check the duration and punctuality of visits.

Updated 16 June 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Jadee’s Nursing Agency is a home care agency providing personal care to 24 people at the time of the inspection. There were 2 people with a learning disability being supported by the service. The service also supported people with physical disabilities, sensory impairments and people living with dementia.

People’s experience of using this service and what we found

Right Support: Improvements had been made to the model of care to maximise people’s choice, control and independence, including in relation to the Mental Capacity Act. Visits were being organised, monitored and delivered safely through effective use of an electronic call monitoring system, which meant people could organise their day as they wished. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care: Staff were described as caring, compassionate, and kind. People told us they were involved in the planning of their own care, and feedback given to the service was listened to and acted on. Improvements had been made to care planning and risk assessments, although further development was still required as some language used was outdated. We have made a recommendation the provider consults best practice guidance as a result. Staff received training on how to meet people’s needs, including specialist training in how to support autistic people and people with a learning disability.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff supported people using services to have good outcomes. There had been numerous changes and improvements made at the service since the last inspection, and the provider was committed to continuous development and working with others. Some new systems and processes still needed further development to show they were embedded and sustained in the longer term. We have made a recommendation about consistent analysis to identify and act on themes and trends. Whilst some regulatory requirements were not fully met, the provider acted promptly when this was raised.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 28 January 2023). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 16 January 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We also undertook this inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met.

Recommendations

We have made a recommendation on the consistent use of person-centred language in care records, development of end of life care plans, and a recommendation on the meaningful analysis of themes and trends to drive improvement.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.